Modified-Active Release Therapy in Patients with Scapulocostal Syndrome and Masticatory Myofascial Pain: A Stratified-Randomized Controlled Trial

Abstract

Modified-active release therapy (mART) was developed to treat patients experiencing upper quarter pain. The objective of the study was to determine the effectiveness of the mART in treating pain, promoting function, and measuring emotions in patients with scapulocostal syndrome (SCS) and masticatory myofascial pain (MMP). A stratified-randomized controlled trial was employed in 38 participants separated into two groups. All participants underwent the same series visual analog scale (VAS), pressure pain threshold (PPT), mouth opening (MO), maximum mouth opening (MMO), craniovertebral angle (CV-angle), and pain catastrophizing scale Thai version (PCS-Thai-version) at the baseline. The mART group underwent the mART program three times a week for 4 weeks with a hot pack and an educational briefing while the control group received only a hot pack and the educational briefing. After treatment, both groups showed significant improvement (p < 0.05) in all parameters except MO, MMO, and CV-angle. When comparing outcomes between the groups, the mART group showed a statistically significant greater number of improvements than did the control group. In conclusion, the mART program can improve pain experienced by patients with SCS and MMP and it can be used as an adjuvant technique with conservative treatment.

The Efficacy of Manual Therapy Approaches on Pain, Maximum Mouth Opening and Disability in Temporomandibular Disorders: A Systematic Review of Randomised Controlled Trials

“…A total of 9639 records were retrieved from our searches, 6009 duplicates were removed, and the remaining 3630 titles and abstracts were screened. Then, 63 potential full texts were assessed for eligibility and 20 trials were included [ 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 ]. The study selection flow diagram is available in Figure 1 .…”

“…Four trials [ 39 , 42 , 44 , 45 ] investigated the effects of manual therapy when compared with control (sham or waiting list) and twelve trials investigated the additional effects of manual therapy when combined with other active intervention on pain intensity [ 35 , 36 , 38 , 41 , 43 , 46 , 47 , 49 , 50 , 51 , 52 , 53 ]. Seven trials used the 0–10 NRS [ 39 , 42 , 46 , 47 , 49 , 50 , 52 ], five trials used the 0–10 VAS [ 36 , 38 , 41 , 43 , 51 ] and four trials used the 0–100 VAS [ 35 , 44 , 45 , 53 ]. For pooling, outcome data were converted to a common 0–10 points scale.…”

“…Five trials [ 36 , 43 , 46 , 47 , 49 ] investigated the immediate additional effects of manual therapy on pain intensity, and two of them were not pooled due to skewed data [ 36 ] and lack of standard deviation measures [ 46 ]. Pooled data provided moderate quality evidence for no immediate additional effect of manual therapy on pain intensity (95% CI −1.61 to 0.10; I² = 0.0; n = 149).…”

“…Three trials [ 42 , 45 , 48 ] investigated the effects of manual therapy when compared with the control (sham or waiting list) and 13 trials investigated its additional effects on MMO [ 35 , 36 , 37 , 41 , 43 , 46 , 47 , 49 , 50 , 51 , 52 , 53 , 54 ]. MMO was assessed with Caliper in six trials [ 36 , 37 , 45 , 47 , 48 , 50 ], with Ruler in three trials [ 51 , 52 , 53 ], with other measurement tools in two trials [ 42 , 49 ] and four trials did not report the instrument used [ 35 , 41 , 46 , 54 ].…”

“…Seven trials [ 35 , 37 , 43 , 46 , 47 , 49 , 54 ] investigated the immediate additional effects of manual therapy on MMO. It was possible to pool data from five of them [ 35 , 37 , 43 , 47 , 49 ] due to a lack of standard deviations [ 46 , 54 ].…”